A routine day for paramedics in Richmond finds them at a hotel where a young woman is overdosing on heroin. She’ll live because of the 911 call her 4-year-old son placed, but the future for this woman and her son is still hazy. This is the sixth time she’s overdosed — her son has seen it enough times to know how to respond — and it will most likely happen again.

Alex Brooks, a trauma technician at MCV and paramedic at Chippenham Hospital, shared this story with us as we investigated the opioid epidemic in the River City. He said this story was a common one, estimating that four to five overdoses occur every day in Richmond. With the introduction of fentanyl and ever-stronger heroin, this epidemic becomes harder and harder to control.

Originally printed in RVA #32 Spring 2018, you can check out the issue HERE or pick it up around Richmond now.

“This summer was pretty rough,” Brooks said. “I recall one particular evening we had seven [overdoses] at one hospital.”

People who suffer from addiction have a complex disease that compels sufferers to seek and use a particular substance. This disease, now called Substance Use Disorder by the American Psychiatric Association, changes the mood, personality, and actions of those struggling with it. On top of the physical and mental challenges individuals face during recovery, there are also social challenges that make long-term recovery very difficult.

A survey conducted by the Johns Hopkins Bloomberg School of Public Health showed that the general public does not believe treatment options for drug addicts are effective, and are opposed to government spending on treatment facilities. Their research also showed that people are averse to working with sufferers in a job space, and most would not welcome a family member’s marriage to someone with the disorder.

In an interview with Johns Hopkins University’s The Hub, lead researcher Colleen L Barry told reporters, “While drug addiction and mental illness are both chronic, treatable health conditions, the American public is more likely to think of addiction as a moral failing than a medical condition.”

Alumni of The Healing Place and work program graduates

However, despite conventional wisdom, there is hope for people who suffer from this disorder — even the mother in that hotel room. We were unable to find out where she is now, but interviews with other locals suffering from the disorder give a partial picture. The people we spoke to hoped that sharing their story could help others by removing some of the stigmas they’ve faced.

“I used to hate to see the sun come up,” said William, who seeks to rejoin society following years of substance use. “I didn’t want to get up and go outside in the freezing cold to stand out there and wait for somebody to get beat, or somebody to score so I can get some. But I couldn’t help myself.”

William (who wished to be identified only by his first name) grew up in Richmond and struggled with heroin for 10 years. He has been in recovery at the Healing Place, a local treatment center for people struggling with substance use disorder, for two years; currently, he’s working on rebuilding the life heroin took from him.

“In step one they talk about powerlessness. I was powerless over the drug,” William said. “Every part of my life, heroin was in it. If I woke up, I needed it; if I went to sleep, I needed it; if I took a shower, I needed it; if I ate, I needed it. If I looked at you, I needed it.”

The disorder does not discriminate across race, gender, or economic lines. Although the face of addiction in mainstream culture is predominantly male and black, men and women from all races and walks of life have suffered from the same dependence.

Marie Pruitt, who is now in recovery, is a former college student from an upper-middle-class background. She talked about how heroin supplanted school and the future she originally saw ahead of her.

“Junior year, I gave up. I felt like school was irrelevant,” she said. “I was just going to go to NOVA [Community College] because there was really no point in me leaving the area because I don’t know people who will sell me drugs outside of the area.”

At first glance, Pruitt and William are polar opposites, but substance use disorder has erased many of the gaps between them. While William is an African American man from poverty, Pruitt is a young white woman from an upper-middle-class household in Fairfax, Virginia, born with every resource to succeed.

Opioid use statewide

However, at the age of 20, Pruitt has been through inpatient rehab five times. She began experimenting with drugs in middle school, and by the time she was 18, Pruitt had tried almost every drug imaginable, and developed a dependence on heroin.

“I felt like [I had lost control] before I even got to heroin. I felt like that with oxies,” said Pruitt. “I had too much money and access, and things were getting really awful.”

No one plans on getting addicted to substances, but their availability both behind the counter and on the street makes it easy for individuals to slip into dependency. Both Pruitt and William were introduced to opiates by people they trusted. A trusted adult in Pruitt’s life would trade prescription opioids to her in exchange for marijuana. Later, Pruitt began buying opioids outright. It was a short step to buying heroin.

“I think the main reason why there is such a big heroin problem now is because of over-prescribing meds,” Pruitt said. With opioids being prescribed so frequently, they become easily accessible for a wide range of people. “They’re available, and you don’t realize they’re that bad. You don’t think it’s bad because it’s in a [prescription] pill bottle.”

Before William could get heroin himself, his uncle would share his heroin with him. In the environment where he grew up, these substances seemed like an inescapable part of life.

“I grew up on misinformation,” William said. “I thought the only way I was going to get out the ghetto or get a pair of Jordans was I had to sell drugs; only way I thought I was gonna get a nice car was I had to sell drugs.”

That misinformation is not isolated to the Richmond community. A study from Harvard’s Equality of Opportunity Project showed that the American Dream of upward income mobility is dissolving. Only 50 percent of children born in 1985 were expected to earn more than their parents did, down from 90 percent of children born in 1940. For people like William, who are born into poverty, that means they are likely to stay in poverty throughout adulthood. In areas of poverty and high unemployment, the people with the most money tend to be drug dealers, who in turn become idolized for their apparent success.

But once William’s uncle introduced him to heroin, the desire to better his socioeconomic status dissolved into a desire to get more heroin. “I’d seen these people living in abandoned houses, and I had a house to go home to and a car, but I’d rather be with them than go home,” William said.

Pruitt’s addiction caused her to value the substance over her own life. “I definitely thought I was gonna die, but I just felt like, whatever.”

Pruitt’s story of upper-class suburban addiction might seem like an outlier in comparison to the stories told in dramas like The Wire, but it’s a fast-growing trend. A research study in JAMA Psychiatry found that there has been an increase in heroin abuse throughout the country — especially in white suburban areas.

Bus and walking routes at The Healing Place

Mike St. Germain, a middle-class family man from the Atlanta suburbs, struggled to help his daughter Tori as she struggled with substance use disorder during her high school years. Her grades started to drop, her mood became more volatile, and the little girl that once happily roamed their house was erased by substances. Like William and Pruitt, Tori’s addiction affected everyone in her life.

“The addiction takes everything around it and sinks these little hooks into it, and just pulls it all the way towards itself,” Mike St. Germain said.

Once a person becomes dependent, life revolves around two things: the substance, and the money to afford it. Another man at the Healing Place, Sean, said, “We live to use and use to live — it’s a vicious cycle.” Family, friends, work, and the future suddenly lose their significance, and the top priority becomes the substance. “Our stories may vary, but the disease of addiction does not discriminate,” he said.

Pruitt felt isolated from everyone she cared about. At her lowest point, many of her friends wouldn’t even speak to her, and she had nowhere to stay. St. Germain’s daughter’s addiction got so bad she gave up her child. “She was in such a bad place she actually signed guardianship over to me and my wife,” St. Germain said.

Nearly a year went by before Tori returned to see her baby girl. Today her daughter is five years old and has a two-year-old sister. Both girls live with their grandparents; just when St. Germain and his wife were expecting to retire, they found themselves becoming parents again.

“I have a lot of conflicting emotions about it because I love my grandkids, I do,” St. Germain said. “But I don’t want to be a parent again.”

Tori is currently in recovery and living with her parents. St. Germain and his wife have done everything they can to help her, and are hopeful that Tori will continue to improve her life. That hope is a common theme for the people who suffer, the people who love them, and the people who work with them in recovery.

“That’s the secret sauce of what works about collegiate recovery, is that you infuse hope,” said Thomas Bannard, Program Coordinator of VCU’s Rams in Recovery. “You give this long-term treatment approach, which is especially necessary with opioids, but is true of all drugs.”

While centers like Rams in Recovery and the Healing Place share a focus on creating a community to serve and support people in recovery, they approach the issue with different models and foundations. Rams in Recovery is a VCU-based support group for students struggling with substance use, while the Healing Place is a recovery treatment center created by CARITAS, a relief organization with an abstinence-based peer-to-peer recovery program. Both centers strive to create an environment of hope for people in recovery, and give them a place to go as they cope with the physical, mental, and social aspects of that process.

“People that have substance use disorders have a marginalized, stigmatized health condition,” Bannard said. “That makes it really challenging to seek help.”

Stories from Healing Place residents in recovery demonstrated the sheer strength it took for these men to get where they are. Arnold, a resident who only used his first name, said, “I had enough. Enough killing myself, enough going in and out of jails. I decided I had to do something different, make a change. My kids were getting older, and I wanted to be there for them — and definitely be there for my grandkids.”

Recovery is a trying experience, requiring hope and support from a community that cares. “You don’t just get recovered. There is nobody who has been an addict, and is recovered, and everything is fine,” Pruitt said. “I know people that are 50 years old and have been clean for 10 years. [They] tell me they still think about it every day.”

Recovery isn’t impossible, but it’s frequently punctuated by relapse. According to the National Institute on Drug Abuse, 40 to 60 percent of those with the disorder experience a relapse. However, what is important is an individual’s ability stay committed through those relapses.

“Relapse is a part of recovery,” said Albert. “What’s important is that when we fall we get back up and keep trying.”

Despite significant relapse rates, all of the individuals we spoke with are succeeding in recovery. Pruitt is currently attending VCU and is working towards a degree that she once thought she wouldn’t live to see. Tori and her children are currently living with St. Germain and his wife, as Tori attempts to rebuild her life. And after two years at the Healing Place, William believes he is finally ready to leave.

“Bad days don’t exist no more,” William said. “I wake up every day and find something to be grateful for — the smallest things. Because I don’t have to wake up and roll over to no dope.”